Abstract
We hypothesized that placental resistance was elevated and transfer reduced in cotyledons from intrauterine growth-restricted (IUGR) fetuses. We perfused 10 cotyledons from term, normally grown fetuses, six from preterm, normally grown fetuses with normal umbilical arterial end-diastolic velocities (EDV), and six from preterm IUGR fetuses (<3rd centile) with absent or reversed umbilical arterial EDV. Perfused cotyledons were pressure-fixed, and villi were observed by scanning electron microscopy. The groups did not differ in fetoplacental resistance at baseline; neither did they differ in the change in resistance that followed the administration of nitroglycerin or angiotensin II. The increase in resistance during hypoxia was similar in the two preterm groups but greater in the term than in the preterm normally grown group (p < 0.05). Groups did not differ in net maternofetal transfer of oxygen or glucose, or in clearance of aminoisobutyric acid or antipyrine. However, glucose consumption was doubled in cotyledons of preterm IUGR versus preterm normally grown fetuses (p < 0.05). Terminal villi of perfused cotyledons from preterm IUGR fetuses displayed less terminal villous branching and budding than preterm controls, as anticipated from previous work. IUGR fetuses with absent or reversed umbilical arterial EDV in vivo may have high placental resistance due to a vasoconstrictive rather than anatomic abnormality and an elevated placental glucose consumption that may impair glucose transfer.
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Abbreviations
- AIB:
-
aminoisobutyric acid
- EDV:
-
end-diastolic velocity
- IUGR:
-
intrauterine growth restriction
- PI:
-
preterm IUGR
- PN:
-
preterm normally grown
- TN:
-
term normally grown
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Acknowledgements
The authors thank Kathey Whiteley, Brenda Knie, Alexsandra Pastrakuljic, Carmine Simone, and Bridgette Byrne for their advice and technical support, and Dr. Angelo Tesoro for HPLC analysis of AIB concentrations. We also thank Lindsay McWhirter and the delivery suite staff of Mount Sinai Hospital for their invaluable assistance in obtaining placentas.
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Supported by a grant from the Medical Research Council of Canada. S.L.A. received support as a Career Investigator of the Heart and Stroke Foundation of Ontario.
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Challis, D., Pfarrer, C., Ritchie, J. et al. Glucose Metabolism Is Elevated and Vascular Resistance and Maternofetal Transfer Is Normal in Perfused Placental Cotyledons from Severely Growth-Restricted Fetuses. Pediatr Res 47, 309–315 (2000). https://doi.org/10.1203/00006450-200003000-00005
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DOI: https://doi.org/10.1203/00006450-200003000-00005
